Individual provider Active NPI

Alan David Entin, PH.D.

  • Psychologist
  • Richmond, VA
National Provider Identifier
1740408343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810000606 Issued in VA
Practice address
1805 Monument Ave Ste 510
Richmond, VA 23220-7005
Phone
(804) 359-0109
NPI assigned
Apr 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810000606 VA Primary

Addresses

Primary practice location

1805 Monument Ave Ste 510
Richmond, VA 23220-7005

Mailing address

1805 Monument Ave Ste 510
Richmond, VA 23220-7005
Phone (804) 359-0109

Other identifiers 1

IdentifierTypeStateIssuer
7712952MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000275 VA Practitioner - Clinical Psychologist 2668502196 Practice locations: Richmond, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Chicago, Pritzker School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Richmond, VA 23227
Phone (804) 359-0109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810000606VAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740408343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 MONUMENT AVE STE 510",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232207005",
            "telephone_number": "804-359-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 MONUMENT AVE STE 510",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232207005",
            "telephone_number": "804-359-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTIN",
        "first_name": "ALAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810000606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7712952",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.